Natural climate solutions for the United States

Partnerships and large-scale models of care that link research and workforce training directly to the delivery of integrated primary health care are essential to saving lives. Without a strong, resilient and responsive health system in place, disease-focused programs and other narrowly targeted health interventions are left with nothing to carry them and cannot succeed. This is the premise of the Doris Duke Charitable Foundation’s African Health Initiative (AHI), which launched in 2007 with the goal to strengthen health systems in sub-Saharan Africa.

In 2015, we shared a series of articles that documented program design, challenges to implementation, and preliminary outcomes from the initiative’s first phase. Now, more than 15 years since the initiative began, we are pleased to present the research findings from the second and final phase of this journey, featured in a supplement to the September 2022 issue of Global Health: Science and Practice.

In the African Health Initiative’s first phase, the foundation awarded four grants to pilot a variety of health systems strengthening interventions in Ghana, Mozambique, Rwanda, Tanzania and Zambia. Though not all activities had the desired impact, several resulted in measurable improvements to health system performance. The encouraging results prompted a follow-up phase, with the Doris Duke Charitable Foundation supporting partnerships in Ethiopia, Ghana and Mozambique to replicate and scale up measures that had proven successful in the earlier phase.